Factors associated with improved Karnofsky performance status after surgery for petroclival meningiomas: a 10-year follow-up retrospective study

Objectives: Petroclival meningiomas, generally, have a good prognosis. However, neurological dysfunction, complications, and recurrence/progression after surgery seriously affect the long-term quality of life of patients. The aim of the current study was to determine factors involved in improvement of Karnofsky performance scores (KPS) after surgery for petroclival meningiomas. Methods: A retrospective study of 163 patients with petroclival meningiomas was conducted. Patients underwent surgery between May 2006 and October 2015 at Sanbo Brain Hospital (China). According to changes in KPS during long-term follow-ups, the patients were divided into improvement and no improvement groups. Prognostic factors associated with improvements in KPS were identified. Results: Compared with the no improvement group, the KPS improvement group had lower preoperative KPS scores (P < 0.001), higher postoperative KPS scores (P = 0.021), and higher frequencies of cranial nerve 1 involvement (P = 0.029). Compared with the no improvement group, the improvement group showed higher postoperative KPS scores (P < 0.001), as well as higher rates of gross total resection, subtotal resection + radiotherapy, and subtotal resection (all P < 0.001). Multivariable analysis revealed that duration of symptoms (OR = 0.985, 95% CI: 0.972-0.998, P = 0.021), preoperative KPS (OR = 0.798, 95% CI: 0.710-0.860, P < 0.001), and postoperative KPS (OR = 1.153, 95% CI: 1.092-1.218, P < 0.001) were independently associated with improvements in long-term KPS after treatment. Cranial nerve involvement, surgical approach, and extent of resection were not associated. Conclusion: Present results suggest that duration of symptoms, preoperative KPS, and postoperative KPS are associated with improved long-term KPS after surgery for petroclival meningiomas.